Provider Demographics
NPI:1346467008
Name:KLEIN, ROBERT WAYNE (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WAYNE
Last Name:KLEIN
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3086
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-3086
Mailing Address - Country:US
Mailing Address - Phone:828-438-8577
Mailing Address - Fax:828-438-8507
Practice Address - Street 1:219 AVERY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3102
Practice Address - Country:US
Practice Address - Phone:828-391-6384
Practice Address - Fax:828-391-1972
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007001923-22363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004910Medicaid
1346467008OtherBC